@article{30595,
  keywords = {Adult, Aged, Cameroon, Cross-Sectional Studies, Female, Filaricides, Humans, Ivermectin, Male, Middle Aged, Nigeria, Odds Ratio, onchocerciasis, Pruritus, Risk Factors, Rural Population, Skin Diseases, Parasitic, Sudan, Uganda},
  author = {Ozoh G A and Murdoch M E and Bissek A-C and Hagan M and Ogbuagu K and Shamad M and Braide E I and Boussinesq M and Noma M M and Murdoch I E and Sékétéli A and Amazigo U V},
  title = {The African Programme for Onchocerciasis Control: impact on onchocercal skin disease.},
  abstract = {<p><strong>OBJECTIVES: </strong>To assess the long-term impact of the African Programme for Onchocerciasis Control on itching and onchocercal skin disease (OSD).</p>

<p><strong>METHODS: </strong>Seven study sites in Cameroon, Sudan, Nigeria and Uganda participated. Two cross-sectional surveys were conducted of communities meso- and hyper-endemic for onchocerciasis before and after 5 or 6 years of community-directed treatment with ivermectin (CDTI). Individuals were asked about any general health symptoms including itching and underwent full cutaneous examinations. Onchocercal skin lesions were documented according to a standard classification.</p>

<p><strong>RESULTS: </strong>Five thousand one hundred and ninety three people were examined in phase I and 5,180 people in phase II. The presence of onchocercal nodules was a strongly significant (P &lt; 0·001) risk factor for all forms of onchocercal skin disease: APOD (OR 1·66); CPOD (OR 2·84); LOD (OR 2·68); reactive skin lesions (OR 2·38) and depigmentation (OR 3·36). The effect of community-directed treatment with ivermectin was profound. At phase II, there were significant (P &lt; 0·001) reductions in the odds of itching (OR 0·32), APOD (OR 0·28); CPOD (OR 0·34); reactive skin lesions (OR 0·33); depigmentation (OR 0·31) and nodules (OR 0·37). Reduction in the odds of LOD was also significant (OR 0.54, P &lt; 0.03).</p>

<p><strong>CONCLUSIONS: </strong>This first multi-country report of the long-term impact of CDTI reveals a substantial reduction in itching and OSD. APOC operations are having a major effect in improving skin health in poor rural populations in Africa.</p>
},
  year = {2011},
  journal = {Tropical medicine & international health : TM & IH},
  volume = {16},
  pages = {875-83},
  issn = {1365-3156},
  url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02783.x/epdf},
  doi = {10.1111/j.1365-3156.2011.02783.x},
  language = {eng},
}